Efficacy of Alternative Medicine Debated

What kind of evidence exists in support of alternative medicine? James Gordon, a psychiatry professor at Georgetown University School of Medicine in Washington, D.C. and director of the Center for Mind/Body Medicine, also in Washington, says, "There is substantial evidence for some therapies. There are a lot of good studies for biofeedback, hypnosis, acupuncture, relaxation and meditation." Here are the findings of some of those studies:

• Herbert Benson, a cardiologist at Harvard Medical School in Cambridge, Mass., has studied what he calls the "relaxation response," a state in which brain wave patterns are altered through meditation or biofeedback to achieve a relaxed state. Benson and his team have documented the effectiveness of the relaxation response in treating premenstrual syndrome (PMS), chronic insomnia and high blood pressure.
• A special issue of Time (Fall 1996) reported that a number of respected researchers, including those at Mount Sinai School of Medicine in New York City and at Stanford University, were examining parallels between the energy or "life force" that acupuncturists attempt to direct and the bioelectrical-magnetic fields that mainstream scientists have shown exist within the body.
• Massage therapy was recently studied at the University of Miami School of Medicine's Touch Research Institute in Coral Gables, Fla. Researchers found that premature babies who were massaged gained weight faster than infants in a control group who were not. The massaged babies also cried less and were calmer overall than babies who were rocked instead.

Defenders of alternative medicine admit that many of the approaches and therapies that they use remain unproved by scientific studies. But they point out that many of the treatments widely used by conventional doctors have not been proved either. An example is the insertion of tubes into the ears of children with ear infections, a practice believed to help but never proven.

Clyde Behney, a former assistant director of Congress' Office of Technology Assessment, says, "It's reasonable to say that much of existing medicine has not met the standards that alternative medicine is being asked to meet." Yet he adds that "[existing medicine] still gets a lot more scrutiny. The data and record-keeping are better, and the peer-review process is better" than that for alternative medicine.

Some backers of alternative therapies say that it may not be possible to reliably test certain therapies in clinical trials. Alternative treatments may draw on several techniques, may be tailored to individuals and may also be combined with conventional medicine. A person might undergo chemotherapy treatments for cancer while attempting to boost his or her immune system through diet and vitamin supplements and while practicing meditation. He or she might also visit an acupuncturist to alleviate the nausea associated with chemotherapy. Such approaches may make it difficult to isolate the effectiveness of a single component of therapy.

Also significant is the high cost of conducting clinical trials. Trials for new drugs tend to be funded by pharmaceutical companies, which stand to profit if the drugs are proven effective. There are no similar incentives to encourage funding for most alternative therapies.

Some members of the alternative medicine community say that while the medical establishment's skepticism can be healthy, it can also lead doctors to rule out therapies without giving them a chance. Just a few years ago, for example, many doctors doubted that diet played a role in preventing heart disease and cancer, while many alternative practitioners stressed its role. Now nearly all medical experts agree that diet is a factor in such illnesses.

Sources

Kolata, Gina. "On Fringes of Health Care, Untested Therapies Thrive." New York Times (June 17, 1996): A1.

Langone, John. "Challenging the Mainstream." Time (Fall 1996): 40.

Lehrman, Sally. "Alternative Medicine: Insurers Cover New Ground." Harvard Health Letter (December 1996): 1.

Miller, Sue. "A Natural Mood Booster." Newsweek (May 5, 1997): 74.

Okie, Susan. "Herbal Relief." Washington Post Health (October 4, 1997): 12.

Relman, Arnold S. "Alternative Medicine: A Shot in the Dark." Wall Street Journal (July 12, 1995).